Hospital bed and network system

ABSTRACT

A hospital bed, patient/nurse call system, and a hospital network are provided. Communication is provided over a packet based communication network.

[0001] This application claims the benefit of United States ProvisionalApplication No. 60/280,002, filed Mar. 30, 2001, entitled “VOICE OVERPACKET IMPLEMENTATION,” which is incorporated herein by reference.

BACKGROUND AND SUMMARY OF THE INVENTION

[0002] The present invention relates to a hospital bed and networkcommunication system. More particularly, to the present inventionrelates to a bed in a patient/nurse call system in a hospital networkwith voice communication implemented over message packets via a packetbased communication network.

[0003] Almost every hospital wing or ward has a patient/nurse callsystem that includes an audio network to allow a patient in a hospitalroom to contact and speak with a nurse or staff member at a nursestation. Typically, the patient may activate a “call” signal bydepressing a button on a small housing connected via hardwire to a unitmounted to the headwall of the patient room. This small housing isgenerally referred to as a pillow speaker, or pillow unit. The headwallunit usually has another wall-mounted call button for easy operation bya nurse. Other input mechanisms may include emergency call buttons, codeblue buttons, or bathroom call buttons. Additionally, the audio networkof these call systems may be used for audio monitoring of a hospitalroom from the nurse station during an extreme emergency, such as a code“blue” status.

[0004] Hospitals also include emergency signaling devices for notifyinghospital personnel of other types of emergency conditions, such as smokedetectors or a fire alarm. Typically, these devices generate audiosignals to convey audible alarms over a hospital intercom system, whichmay or may to be interconnected with the patient room audio network.Some hospitals also use bed monitoring devices with bed sensors thatindicate bed conditions such as “brakes on,” mattress firmness (forinflatable mattresses), or incontinence.

[0005] Historically, the duplicity of call and information systems inhospitals has complicated the organization, maintenance and effectivedissemination of all of the useful information that is generated. Ifthese systems cannot be operated in a simple, user-friendly manner, theycan add to the stress level of nurses and staff. As a result, their jobsare made more difficult, rather than made easier. Additionally, use ofmultiple call and information systems in a hospital adds to the costs ofhealth care, due to costs associated with purchase, installation andmaintenance of the various components of these multiple systems, alongwith training personnel how to use the system.

[0006] U.S. Pat. Nos. 5,561,412, 5,699,038, and 5,838,223, which areincorporated herein by reference, disclose integration of call andinformation systems through a private branch exchange (“PBX”) voice/dataswitching system that establishes audio links and data distributionbetween a master station and other stations. The disclosedcommunications networks are basically telephone networks that providesynchronous, full duplex, voice and data communications. Additionally,non-voice information signals from emergency signaling devices, bedmonitoring devices, locating and tracking transmitters, and/or variousother pieces of equipment are converted to digital data and transmittedthrough the PBX to the distant end over a low-speed channel.

[0007] Although PBX based systems provide several advantages overhistorical approaches, there are still needs to reduce equipment andmaintenance costs, to increase expandability and versatility, and toincrease the effective bandwidth of patient/nurse call systems inhospital networks.

[0008] The present invention fulfills the above needs, among others, byproviding a system and method for a hospital bed, a patient/nurse call,and a hospital network using voice and data over packet implementation.

[0009] In one illustrated embodiment of the present invention, apatient/nurse call system transmitter being configured to periodicallytransmit an identification signal unique to that transmitter, aplurality of patient locations, each of the plurality of patientlocations being associated with a patient and including a receiverconfigured to receive the identification signals from the plurality oftransmitters, and a master station remote from the patient locations,the master station being configured to receive signals from thereceivers to indicate locations of the hospital personnel. The systemalso comprises a packet based communication network, and a plurality offirst audio stations coupled to the packet based communication network.A first audio station is located at each patient location and isidentified by a unique address. Each first audio station includes afirst processor, a first microphone, a first speaker, and a firstconverter configured to receive audio signals from the first microphone,to generate voice data in a packet based data stream correspondingthereto, and to transmit the packet based data stream over thecommunication network. The first converter also is configured to receivea packet based data stream from the communication network, to generateaudio signals corresponding thereto, and to transmit the audio signalsto the first speaker. The system further comprises a second audiostation located at the master station and coupled to the packet basedcommunication network. The second audio station is identified by aunique address and includes a second processor, a second microphone, asecond speaker, and a second converter configured to receive audiosignals from the second microphone, to generate voice data in a packetbased data stream corresponding thereto, and to transmit the packetbased data stream over the communication network. The second converteralso is configured to receive a packet based data stream from thecommunication network, to generate audio signals corresponding thereto,and to transmit the audio signals to the second speaker, therebypermitting audio communication between personnel located at the firstand second audio stations.

[0010] In an illustrated embodiment, a server is coupled to the packetbased communication network. The server is configured to instruct theplurality of first audio stations to send the packet based data streamto and receive the packet based data stream from the second audiostation. The server is further configured to instruct the second audiostation to send the packet based data stream to and receive the packetbased data stream from the first audio stations.

[0011] In another illustrated embodiment of the present invention, apatient/nurse call system comprises a packet based communicationnetwork, a plurality of transmitters, each of the transmitters beingconfigured to be carried by a hospital caregiver and to periodicallytransmit an identification signal that identifies the transmitters and aplurality of receivers configured to receive the identification signalsand generate identification data corresponding thereto. The receiversare configured to convert the identification data into a packet baseddata stream and to transmit the packet based data stream over thecommunication network. The system also includes a first audio stationcoupled to the packet based communication network and being identifiedby a unique address. The first audio station includes a first processor,a first microphone, a first speaker, and a first converter configured toreceive audio signals from the first microphone, to generate voice datain a packet based data stream corresponding thereto, and to transmit thepacket based data stream over the communication network. The firstconverter also is configured to receive a packet based data stream fromthe communication network, to generate audio signals correspondingthereto, and to transmit the audio signals to the first speaker. Thesystem further includes a second audio station coupled to the packetbased communication network and being identified by a unique address.The second audio station includes a second processor, a secondmicrophone, a second speaker, and a second converter configured toreceive audio signals from the second microphone, to generate voice datain a packet based data stream corresponding thereto, and to transmit thepacket based data stream over the communication network. The secondconverter also is configured to receive a packet based data stream fromthe communication network, to generate audio signals correspondingthereto, and to transmit the audio signals to the second speaker. Thesystem still further includes a server coupled to the receivers, thefirst audio station, and the second audio station via the packet basedcommunication network. The server is configured to instruct the firstaudio station and the second audio station regarding at least one ofestablishing an audio connection and terminating an audio connectionbased at least in part on the identification data, thereby permittingaudio communication between personnel located at the first and secondaudio stations.

[0012] In the illustrated embodiment, the receiver is further configuredto generate location data based at least in part on the identificationsignals, and the server is further configured to instruct the firstaudio station and the second audio station regarding at least one ofestablishing an audio connection and terminating an audio connectionbased at least in part on the location data.

[0013] In yet another illustrated embodiment of the present invention, amethod for patient and nurse communication over a hospital networkcomprises the steps of receiving at least one of an identificationsignal from a transmitter carried by a hospital caregiver, a bed statussignal, a chair call signal, a shower status signal, and a remote codesignal, generating non-voice data corresponding to the received signal,and generating voice data. The method also includes sending a firstnotification packet from a first address into a packet network, sendinga first request packet from a second address into the packet network inresponse to the first notification packet, transporting the non-voicedata in packets between the first address and the second address inresponse to the first notification packet and the first request packet,and transporting the voice data in packets between the first address andthe second address in response to the first notification packet and thefirst request packet.

[0014] In a further illustrated embodiment of the present invention, apatient support apparatus comprises a patient support, and a computercoupled to the patient support. The computer provides an audio stationon the patient support configured to communicate with a packet basedcommunication network. A display coupled to the computer. A data deviceis also coupled to the computer. The data device includes at least oneof a psychological monitor, a treatment device, and a therapy device,the computer being configured to receive data from the data device,convert the data received from the data device to a packet based datastream, and transmit the packet based data stream to the packet basedcommunication network.

[0015] In an illustrated embodiment, a plurality of data devices arecoupled to the computer including an input device to input data andinstructions concerning the patient, and a sensing device including atleast one of a heart rate sensor, a respiratory rate sensor, aneurological monitoring sensor, and a temperature sensor. Also inillustrated embodiments, the data device includes at least one of avital signs monitor, an IV pump, a ventilator, a defibrilator, and acompression boot. In illustrated embodiments, the patient support is ahospital bed or a patient assist cart.

[0016] Additional features of the invention will become apparent tothose skilled in the art upon consideration of the following detaileddescription of the drawings exemplifying the best mode of carrying outthe invention as presently perceived.

BRIEF DESCRIPTION OF THE DRAWINGS

[0017]FIG. 1 is an illustrative architecture of a system fortransmitting voice and data in packets over a network;

[0018]FIG. 2 is an illustrative system architecture interconnecting twoaudio stations and a server computer;

[0019]FIG. 3 is an illustrative flow diagram for a process of voice overpacket communication between the two audio stations in the systemillustrated in FIG. 2;

[0020]FIG. 4 is an illustrative system architecture interconnectingmultiple audio stations, a server computer, and a server audio station;

[0021]FIG. 5 is an illustrative flow diagram of a first process of voiceover packet paging for the system illustrated in FIG. 4;

[0022]FIG. 6 is an illustrative flow diagram of a second process ofvoice over packet paging for the system illustrated in FIG. 4; FIG. 7 isan illustrative system architecture that interconnects multiple audiostations, multiple server computers, and multiple server audio stationsthrough a traffic management device;

[0023]FIG. 8 is an illustrative flow diagram describing a process forvoice over packet communication in the system illustrated in FIG. 7;

[0024]FIG. 9 describes an illustrative prioritization scheme used toimprove quality of service; and

[0025]FIG. 10 illustrates an arrangement in which various signalingequipment is coupled to data devices within the system architecture ofFIG. 1.

DETAILED DESCRIPTION OF THE DRAWINGS

[0026] Transmitting voice data and/or non-voice data in packets over anetwork requires that a protocol be selected and implemented. Protocolsspecify methods for encoding, packetizing, and decoding voice signals aswell as for call signaling, controlling, and packet exchange. Severalcompeting protocols have been developed. The leading protocol to date isH.323 developed by the International Telecommunications Union. (ITU).Another protocol is Session Initiation Protocol (SIP) developed by theInternet Engineering Task Force (IETF). Media Gateway Control Protocol(MGCP) and Megaco are two others. Most protocols are suitable fortransmission of voice over an Internet Protocol (IP) network. However,some protocols will also support voice over an Asynchronous TransferMode (ATM) network. In any event, one of ordinary skill in the art willreadily appreciate that a number of well known protocols may be used inalternative embodiments of the present invention.

[0027]FIG. 1 is an illustrative architecture of a system 100 fortransmitting voice and data in packets over a network. The system 100includes any suitable number of intra-room networks 110. Each intra-roomnetwork 110 couples a number of data devices 120 to an audio station 130(discussed in further detail below). For example, U.S. Pat. Nos.5,561,412; 5,699,038; and 5,838,223 (which have been incorporated hereinby reference) disclose similar intra-room networks. Each data device 120is suitably configured to receive inputs from various hospital beds,patient/nurse call systems, and/or personnel and asset locating andtracking systems and to communicate the corresponding information to therespective audio station 130.

[0028] Each audio station 130 (discussed in further detail below)couples the respective intra-room network 110 to a packet based network140. In the exemplary embodiment, the packet based network is configuredin a “client/server” (or “two-tier”) architecture. In a typicalclient/server architecture, each computer or process of a system isviewed as either a “client” or a “server.” Generally, a server managesnetwork resources such as file storage, printing operations, databasequeries, network communications, etc. To enhance efficiency, variousservers may be dedicated to the management of various differentresources. For example, a computer that provides (i.e., “serves up”)Internet access is sometimes referred to as a “web server.” A clientgenerally provides a user interface and often provides additionalprocessing power remote from the server. Typically, clients can sharefiles and programs amongst themselves as well as retrieve data from theserver(s). In any event, the packet based network 140 may be anysuitable collection of devices that is connected to share information inpackets. To this end, it should be readily appreciated that the packetbased network 140 may include multiple Local Area Networks (“LANs”)and/or Wide Area Networks (“WANs”) that are operably coupled to oneanother via routers, switches, hubs, gateways, proxies, and/or firewalls(not shown). However, although the exemplary network 140 is implementedin a client/server architecture, it is noted that alternativeembodiments may be implemented in a peer-to-peer architecture or anyother suitable configuration.

[0029] In general, in the exemplary client/server architecture (notedabove) each audio station 130 is configured to operate as a client onthe packet based network 140. Accordingly, each exemplary audio station130 is illustratively implemented with a personal computer system, adesktop computer system, and/or a workstation manufactured by DellComputer Corporation of Round Rock, Tex., Gateway, Inc. of San Diego,Calif., or Compaq Computer Corporation of Houston, Tex. It should beappreciated that each audio station 130 may alternatively, or inaddition, include a network appliance and/or any other suitable packetbased network enabled device.

[0030] Additionally, each audio station 130 includes a microphone (notshown) that provides an analog signal to a code-decode (“CODEC”)integrated circuit (“IC”) (not shown). The CODEC periodically samplesthe analog voice signal and generates numerical values representing theamplitudes of the signal at the sample times. The sampling is done arate high enough to ensure the voice can be recreated with good qualityby equipment located at a remote or distant end of the system, such as,for example, another of the audio stations 130 or a server computer 150that is coupled to the packet based network 140. Each audio station 130further includes a speaker (not shown) and a digital-to-analog (“D/A”)converter (not shown). The D/A receives numerical values representingaudio signals and generates corresponding analog signals, which drivethe speaker.

[0031] Each audio station has an address that identifies it on thepacket based network 140. To transmit data, an audio station 130 buildsdigital signals into a message packet along with all the headerinformation such as source address, destination address, checksum,packet size, etc. Each message is transmitted onto the network and isaddressed to another audio station at the distant end. For voice data,the distant end station converts the digital signal to analog forsounding through its speaker. To ensure good voice quality, packets areconsistently delivered to the distant end at a rate as fast as they aresampled at the originating audio station 130. It should be readilyappreciated that any suitable number of similarly configured audiostations 130 and/or other devices may be coupled to the packet basednetwork 140 to effectuate the communication of voice and otherinformation as discussed in further detail below.

[0032] The server computer 150 is configured to provide serveroperations for the packet based network 140. To this end, the exemplaryserver computer 140 is illustratively implemented with a server computersystem manufactured by Dell Computer Corporation of Round Rock, Tex.,Gateway, Inc. of San Diego, Calif., or Compaq Computer Corporation ofHouston, Tex. Further, the server computing device 140 mayalternatively, or in addition, include network server appliances, serverfarms, server clusters, network accessible storage devices, and/or anyother device suitable for executing operations according to the presentinvention. The server computer 150 is further configured to code anddecode voice signals and data in a similar manner to the audio station130.

[0033] It should be readily appreciated that any suitable number ofpacket based devices (such as, for example, client computer 160,Admission/Discharge/Transfer system (“ADT”) gateway 170, and/or webserver 180, etc.) may be coupled to the packet based network 140 toeffectuate packet based communication of any suitable information intoor out of the packet based network 140 in a manner which is well known.Furthermore, it should be appreciated that such additional packet baseddevices may in turn be suitably coupled to other networks (such as, forexample, hospital information system network 190, etc.), which may inturn be suitably coupled to their own respective databases (such as, forexample, ADT database 200, etc.) and/or their respective user interfaces(such as, for example, ADT hospital users 210, etc.).

[0034]FIG. 2 is an illustrative system architecture 300 interconnectingtwo audio stations 130 ₁, 130 ₂ and a server computer 150 ₁ with apacket based network 140 ₁. Exemplary audio station 130 ₁, exemplaryaudio station 130 ₂, exemplary server computer 150 ₁, and exemplarypacket based network 140 ₁ are implemented in similar manners to audiostation(s) 130, server computer 150, and packet based network 140,respectively (discussed above in connection with FIG. 1). FIG. 3 is anillustrative flow diagram for a process 400 of voice over packetcommunication between the two audio stations 130 ₁, 130 ₂ in the systemillustrated in FIG. 2.

[0035] At step 410, audio station 130 ₁ initiates a call. It should beappreciated that the call may be in response to a user input (forexample, actuation of a call button by a caregiver or a patient) or anautomatic signal from monitoring equipment that is provided to audiostation 130 ₁ by a data device (see FIG. 1).

[0036] Upon initiation of the call, audio station 130 ₁ sends a messageover network 140 ₁ to server computer 150 ₁ (step 420). Server computer150 ₁ displays this call information on a user terminal and alsosearches a database to determine which patient room the call is from andwhat caregiver is assigned to that patient. If a caregiver at audiostation 130 ₂ wants to answer the call, then that caregiver inputs arequest into audio station 130 ₂ to answer the call through a suitableuser interface and/or data device. In response to the request to answerthe call, at step 430 audio station 130 ₂ sends a request to servercomputer 150 ₁ for permission to establish an audio connection withstation audio station 130 ₁.

[0037] At step 440, server computer 150 ₁ determines whether thecaregiver at audio station 130 ₂ should have permission to take thecall. It should be appreciated that server computer 150 ₁ may make thisdetermination based on predetermined software logic which may considerinputs from other system users (such as, for example, a head or “charge”nurse who is provided an indication of the call request status by servercomputer 150 ₁ or any other manager or supervisor), which mayalternatively or in addition consider location and/or trackinginformation from a data device(s) that indicates the identity andwhereabouts of the caregiver who is requesting to answer the call (seeFIG. 10), and/or which may consider any other suitable inputs orvariables.

[0038] If the server computer 150 ₁ determines at step 440 thatpermission not granted for the caregiver at audio station 130 ₂ toanswer the call, then at step 450 server computer 150 ₁ sends a messageto audio station 130 ₂ indicating a denial of the request to answer thecall and the server computer 150 ₁ terminates the process 400.

[0039] If the server computer 150 ₁ determines at step 440 thatpermission granted for the caregiver at audio station 130 ₂ to answerthe call, then server computer 150 ₁ bypasses step 450 and at step 460the server computer 150 ₁ sends a message(s) over network 140 ₁ to audiostations 130 ₁, 130 ₂ that instructs them to transmit their voicepackets to each other over the network 140 ₁, thereby establishing avoice connection. At step 470, audio stations 130 ₁, 130 ₂ build theirvoice data into message packets (i.e., they “packetize” the voice data)in response to the instruction(s) from server computer 150 ₁ to transmitvoice packets, and they transmit the packets between each other.

[0040] At step 480, the caregiver at audio stations 130 ₂ initiates arequest to end the audio connection (or to “hang up”). It is noted thatthe request to end the call may include an active request (such as, forexample, actuation of a “voice end” button), and in alternativeembodiments may in addition or alternatively include a passive request(such as, for example, a locating and tracking detection that thecaregiver has left a proximity of the audio stations 130 ₂). In responseto the request to end the audio connection, audio station 130 ₂ sends amessage to server computer 140 ₁ that requests termination of the audioconnection. In response to the request to termination the audioconnection generated at step 480, at step 490 server computer 150 ₁sends a message to both audio stations 130 ₁, 130 ₂ that instructs themto stop their voice transmissions, thereby terminating the audioconnection.

[0041] Next, FIG. 4 is an illustrative system architecture 500interconnecting multiple audio stations 130 ₃, 130 ₄, 130 ₅, 130 ₆, aserver computer 150 ₂, and a server audio station 150 ₃. This exemplaryembodiment provides a paging feature. Paging consists of transmittingvoice from one audio station to one or more additional audio stations inone direction only. It should be appreciated that exemplary audiostations 130 ₃, 130 ₄, 130 ₅, 130 ₆, exemplary server computer 150 ₂,and exemplary packet based network 140 ₂ are implemented in similarmanners to audio station(s) 130, server computer 150, and packet basednetwork 140, respectively (discussed above in connection with FIG. 1);and exemplary server audio station 150 ₃ is implemented in a similarmanner to server computer 150 (with suitable software and/or hardwaremodifications to perform the relevant operations discussed herein).

[0042]FIG. 5 is an illustrative flow diagram of a first process 600 ofvoice over packet paging for the system illustrated in FIG. 4. To send apage, at step 610 a user inputs a request to server computer 150 ₂ toinitiate a selected page to desired audio stations. The discussion thatfollows in connection with FIG. 5 assumes (as an example) that audiostations 130 ₃, 130 ₄, 130 ₅ are selected. At step 620, server computer150 ₂ sends instructions to the selected audio stations (the “pagegroup”) to receive voice broadcast (page) packets and generatecorresponding sounds via their speakers. It is noted that any audiostations not selected do not receive such instructions (see step 630).

[0043] At step 640, server computer 150 ₂ sends instructions to serveraudio station 150 ₃ to begin broadcasting the selected page in voicedata packets. The page is broadcast suitably repeatedly until the userterminates the page (see step 650).

[0044] At step 650, the user inputs a request to terminate the page (orto “hang up”) into server computer 150 ₂. The request to end the pagemay include an active request (such as, for example, actuation of a“page end” button), and in alternative embodiments may in addition oralternatively include a passive request (such as, for example, alocating and tracking detection that the user has left a proximity ofthe server computer 150 ₂).

[0045] At step 660, the server computer 150 ₂ sends instructions to thepreviously selected audio stations (see step 620, above) to stopsounding voice broadcast (page) packets. At step 670, server computer150 ₂ sends instructions to server audio station 150 ₃ to stopbroadcasting the voice packets.

[0046]FIG. 6 is an illustrative flow diagram of a second process 700 ofvoice over packet paging for the system illustrated in FIG. 4. To send apage using the process 700, at step 710 a user inputs a request toserver computer 150 ₂ to initiate a selected page to desired audiostations. The discussion that follows in connection with FIG. 6 assumes(as an example) that audio stations 130 ₃, 130 ₄, 130 ₅ are selected. Atstep 720, server computer 150 ₂ sends instructions to server audiostation 150 ₃ to transmit the selected page in voice data packetsaddressed specifically (and only) to the selected audio stations 150 ₂.At step 730, the selected audio stations receive the page packets andproduce corresponding audio from their speakers.

[0047] At step 740, the user inputs a request to terminate the page (orto “hang up”) into server computer 150 ₂. The request to end the pagemay include an active request (such as, for example, actuation of a“page end” button), and in alternative embodiments may in addition oralternatively include a passive request (such as, for example, alocating and tracking detection that the user has left a proximity ofthe server computer 150 ₂). At step 750, server computer 150 ₂ sendsinstructions to server audio station 150 ₃ to stop broadcasting thevoice packets.

[0048]FIG. 7 is an illustrative system architecture 800 thatinterconnects multiple audio stations 130 ₇, 130 ₈, 130 ₉, 130 ₁₀, 130₁₁, 130 ₁₂, 130 ₁₃, 130 ₁₄, multiple server computers 150 ₃, 150 ₄, andmultiple server audio stations 150 ₅, 150 ₆, and multiple packet basednetworks 140 ₃, 140 ₄ through a traffic management device 810. It shouldbe appreciated that exemplary audio stations 130 ₇, 130 ₈, 130 ₉, 130₁₀, 130 ₁₁, 130 ₁₂, 130 ₁₃, 130 ₁₄, exemplary server computers 150 ₃,150₄, and exemplary packet based networks 140 ₃, 140 ₄ are implemented insimilar manners to audio station(s) 130, server computer 150, and packetbased network 140, respectively (discussed above in connection with FIG.1), and exemplary server audio stations 150 ₅, 150 ₆, are implemented ina similar manner to server computer 150 (with suitable software and/orhardware modifications to perform the relevant operations discussedherein).

[0049] When the number of networked devices increases, the amount ofnetwork traffic also increases. To increase efficiencies, the network isbroken into smaller segments and the segments are interconnected usingintelligent devices that manage the traffic between the segments. Tothis end, the traffic management device 810 suitably includes bridges,switches, routers, and other known devices. In a manner that is wellknown, the traffic management device dynamically “learns” the addressesof the devices on each network segment and manages communicationsbetween the network segments.

[0050]FIG. 8 is an illustrative flow diagram describing a process 900for voice over packet communication in the system illustrated in FIG. 7.In general, the traffic management devices look at the source anddestination of each packet transmitted on the network to determine ifthe packet is destined for a device on a segment different than thesource. If so, the traffic management device retransmits the packet ontothe appropriate network segment. This method reduces traffic on eachsegment to only packets transmitted or received by devices on thatsegment.

[0051] More particularly, at step 910 a user places a call (i.e., seeksto initiate an audio connection) through one of the audio stations(audio station 130 ₇, for example). At step 920, the calling audiostation sends a message to the server computer that is on its networksegment (in this example, the message is sent to server computer 150 ₃over packet based network 140 ₃) indicating that the calling audiostation has requested an audio connection, and that server computersends message(s) over the network indicating that the calling audiostation has placed the call. Further, the traffic management devicerelays the indication that the calling audio station has requested anaudio connection to the distant network segment (in this example, packetbased network 140 ₄). At step 930, a user at a distant audio station (inthis example, audio station 130 ₁₃) indicates a request to answer thecall. Accordingly, the distant audio station sends a request forpermission to answer the call to the server computer on its networksegment (in this example, to server computer 150 ₄ over packet basednetwork 140 ₄). At step 940, the server computer on the network segmentthat is distant from the caller (i.e., server computer 150 ₄ in thisexample) transmits the request for permission to answer the call overits respective network segment.

[0052] At step 950, the traffic management device 810 determines thatthe message packets indicating the request for permission to answer thecall are addressed to the server computer that is on the same networksegment as the caller, and, accordingly, the traffic management devicerelays the packets onto the network segment of the caller. At step 960,the server computer on the network segment of the caller (i.e., the“proximate server”) determines whether the distant audio station thathas requested permission to answer the call should have permission toanswer the call. If so, then the proximate server computer proceeds tostep 980; otherwise, the proximate server computer sends a message tothe distant audio station that has requested the permission indicatingthat the request to answer the call is denied (step 970) and theremaining steps are bypassed.

[0053] At step 980, the proximate server computer transmits a messageonto its network segment indicating approval of the distant audiostation's request for permission to answer the call. At step 990, thetraffic management device 810 determines that the packets transmitted bythe proximate server computer (step 980) are addressed to a device onthe distant network segment and, accordingly, relays the packets to thedistant segment.

[0054] At step 1000, the proximate server computer sends a message tothe audio station that initiated the call and the distant servercomputer sends a message to the audio station that has requestedpermission to receive the call, and in response these two audio stationsbegin transmitting voice data packets between them. At step 1010, thetraffic management device 810 determines that the streaming packets areaddressed to audio stations on different network segments and relays thepackets between the segments as appropriate. The audio stations soundthe corresponding audio on their speakers.

[0055] At step 1020, the user who answered the call inputs a request toterminate the audio connection (or to “hang up”) into the servercomputer on its network segment. The request to end the call may includean active request (such as, for example, actuation of a “call end”button), and in alternative embodiments may in addition or alternativelyinclude a passive request (such as, for example, a locating and trackingdetection that the user has left a proximity of the server computer fromwhich the user answered the call. At step 1030, the proximate servercomputer sends a message to the audio station that initiated the calland the distant server computer sends a message to the audio stationthat received the call, and in response the two audio stations stoptransmitting voice data packets between them.

[0056] Next, FIG. 9 shows an illustrative prioritization scheme 1100 forimproving quality of service (i.e., “voice quality,” or “QOS”). Whentransmitting voice over a packet network, increased bandwidth for theduration of the audio connection is one way to ensure good quality,real-time voice communication. Most telephony systems have historicallydedicated a channel for each voice connection in order to guaranteebandwidth. However, when sending voice in packets over an asynchronousnetwork, guaranteeing bandwidth is much more difficult. This isespecially true when the network is also supporting numerous other voiceand data applications.

[0057] Several methods have been employed to deal with the problem ofvoice quality of service. One solution has been to move to higher speednetworks. Another is to design networks that provide multiple pathsthrough which packets can travel. Yet another is to use routers andswitches that provide quality of service features. Devices with thesefeatures are able to recognize the type of each packet it is processing.These devices can then give voice packets a priority over other packettypes so that they are processed sooner. Illustratively, some routersand switches will purposely introduce delays in the processing of lowerpriority packets to cause the sending devices to slow the rate at whichpackets are sent. This reduces the amount of bandwidth used by lowpriority traffic.

[0058] As shown in FIG. 9, a server computer categorizes the types oftraffic on the network into levels of priority to be postponed and/orthrottled back to free bandwidth for voice traffic depending on thepriority level and then number of simultaneous voice connections. If avoice connection is established, low priority traffic such as messagesrelated to changes in the location of equipment, is postponed until thevoice connection is terminated. If two voice connections areestablished, both the lowest priority and second from lowest prioritytraffic is postponed.

[0059] More particularly, the exemplary embodiment includes fivepriority levels (where “1” indicates the highest and “5” indicates thelowest priority), as follows: Priority Information/Data Type 1 calls 2people movements/tracking 3 maintenance 4 routine status updates 5equipment movements/tracking

[0060] Referring still to FIG. 9, when one or more audio connections areestablished, the server computer(s) instruct all audio stations topostpone transmission of priority 5 (equipment movements/tracking)messages; otherwise, the server computer(s) instruct all audio stationsto allow transmission of priority 5 messages.

[0061] Additionally, when two or more audio connections are established,the server computer(s) instruct all audio stations to slow transmissionof priority 4 (routine status updates) messages to 25% of the full rate;otherwise, the server computer(s) instruct all audio stations to allowtransmission of priority 4 messages at the full rate.

[0062] Additionally, when three or more audio connections areestablished, the server computer(s) instruct all audio stations to slowtransmission of priority 3 (maintenance) messages to 50% of the fullrate; otherwise, the server computer(s) instruct all audio stations toallow transmission of priority 3 messages at the full rate.

[0063] Additionally, when four or more audio connections areestablished, the server computer(s) instruct all audio stations to slowtransmission of priority 2 (people movements/tracking) messages to 75%of the full rate; otherwise, the server computer(s) instruct all audiostations to allow transmission of priority 2 messages at the full rate.

[0064] Next, FIG. 10 illustrates an arrangement 1200 in which varioussignaling equipment is coupled to data devices within the systemarchitecture of FIG. 1. For example, locating and tracking systems thattrack movement of caregivers and equipment through hospital facilitiesare known. Some such systems include badges that use infrared, radiofrequency, ultrasonic, or other types of transmitters that periodicallytransmit identification signals. In operation, receivers throughout thefacility (not shown) suitably detect the identification information. Itis noted that locating and tracking inputs for the present invention maybe implemented with a COMposer® system or a COMLNX™ system (availablefrom Hill-Rom NetLinx located in Cary, N.C.) or similar system. Further,as illustrated in FIG. 10, one or more data devices 120 ₁ may beconfigured to receive identification signals from locating and trackingbadges 1210, and may be further configured to receive informationsignals from various other signaling equipment such as chair calldevices 1220, pillow speakers 1240, and/or a hospital bed status unit1230. U.S. Pat. Nos. 5,561,412; 5,699,038; and 5,838,223 (which havebeen incorporated herein by reference) disclose the operation of suchequipment and, furthermore, suitable alternative signaling equipment isknown. Additionally, it is noted that audio station(s) 130 ₁₅ may becombined or otherwise integrated with the respective data device(s) 120₁ and/or any suitable number of the various signally devices.

[0065] In an illustrated embodiment of the present invention, a hospitalbed is provided with an audio station 130 to communicate with thenetwork 140. In this embodiment, the hospital bed itself includes acomputer and provides audio station 130 for communicating voice data andother non-voice from the hospital bed to the network. In anotherembodiment of the present invention, the audio station 130 is providedon a cart or other device which moves with the patient through thehospital to provide a patient point of care computer system. Embodimentsof a computer system on a bed or cart are included in U.S. patentapplication Ser. No. 09/849,580, filed May 4, 2001 and U.S. Ser. No.60/310,092, filed Aug. 3, 2001, the disclosures of which are expresslyincorporated by reference herein.

[0066] By providing the audio station 130 on the hospital bed or cart,the system of the present invention provides network communication fromthe area around the patient point of care to the hospital informationnetwork 190 at all times. In other words, when the hospital bed is movedfrom room to room, a network connection is made between the audiostation 130 on the hospital bed and the network 140. Likewise, when thepatient care cart moves with a patient through the facility,communication between the audio station 130 on the patient care cart andthe network 140 is made. Such communication is accomplished through awired connection or a wireless data connection within the hospital.Therefore, the patient and caregiver have improved data and voicecommunication over the network at the patient point of care. Caregivershave access to patient data including video information, and voicecommunication from a remote location to the patient's bedside.Therefore, caregivers can access patient chart information, testresults, etc. from a remote location.

[0067] Some of the data devices 120 are illustratively physiologicalmonitors, treatment devices, and therapy devices. A network computer inthe room, on the bed, or on a patient cart is coupled to the data deviceby an RS-232 port or other suitable connector. The computer processessignals from the monitors, treatment devices, and therapy devices on areal time basis. The monitors, treatment devices, and therapy devicesinclude, but are not limited to, heart rate monitors, temperaturesensors, blood pressure monitors (invasive and noninvasive), EKGmonitors, blood oxygen sensors, capnographs, ventilators, IV pumps,scales, and chest drainage monitors. Additional details of the computerand data devices are disclosed in U.S. patent application Ser. No.09/849,580, filed May 4, 2001, and U.S. patent application Ser. No. U.S.patent application Ser. No. 60/310,092, filed on Aug. 3, 2001, thedisclosures of which are incorporated herein by reference.

[0068] In another illustrated embodiment, the computer on the bed orcart is used to provide a medication scan, TV, phone, and bed controls,internet access, e-mail, music or DVD players, and nurse call. Computeris also coupled to a display. Illustratively, display 24 is a touchscreen display which can be used as both a TV terminal and a computerdisplay. Software provides a keyboard emulation on display to permit auser to input information to computer using touch screen display. It isunderstood that any conventional input device such as a pen or stylusbased input, a keyboard, a mouse, a joy stick, a voice recognitioninput, or other suitable input device may be used to input informationinto computer.

[0069] Although the invention has been described in detail withreference to certain illustrated embodiments, variations andmodifications exist within the scope and spirit of the present inventionas defined in the following claims.

1. A patient/nurse call system comprising: a plurality of transmittersadapted to be carried by hospital personnel, each transmitter beingconfigured to periodically transmit an identification signal unique tothat transmitter; a plurality of patient locations, each of theplurality of patient locations being associated with a patient andincluding a receiver configured to receive the identification signalsfrom the plurality of transmitters; a master station remote from thepatient locations, the master station being configured to receivesignals from the receivers to indicate locations of the hospitalpersonnel; a packet based communication network; a plurality of firstaudio stations coupled to the packet based communication network, afirst audio station being located at each patient location and beingidentified by a unique address, each first audio station including afirst processor, a first microphone, a first speaker, and a firstconverter configured to receive audio signals from the first microphone,to generate voice data in a packet based data stream correspondingthereto, and to transmit the packet based data stream over thecommunication network, the first converter also being configured toreceive a packet based data stream from the communication network, togenerate audio signals corresponding thereto, and to transmit the audiosignals to the first speaker; and a second audio station located at themaster station and coupled to the packet based communication network,the second audio station being identified by a unique address andincluding a second processor, a second microphone, a second speaker, anda second converter configured to receive audio signals from the secondmicrophone, to generate voice data in a packet based data streamcorresponding thereto, and to transmit the packet based data stream overthe communication network, the second converter also being configured toreceive a packet based data stream from the communication network, togenerate audio signals corresponding thereto, and to transmit the audiosignals to the second speaker, thereby permitting audio communicationbetween personnel located at the first and second audio stations.
 2. Thepatient/nurse call system of claim 1, further comprising a servercoupled to the packet based communication network, the server beingconfigured to instruct the plurality of first audio stations to send thepacket based data stream to and receive the packet based data streamfrom the second audio station, and further being configured to instructthe second audio station to send the packet based data stream to andreceive the packet based data stream from the first audio stations. 3.The patient/nurse call system of claim 2, further comprising an audioserver station coupled to the packet based communication network, theaudio server station being configured to broadcast the packet based datastream to the first audio station and the second audio station.
 4. Thepatient/nurse call system of claim 3, wherein the server is furtherconfigured to instruct the audio server station to broadcast the packetbased data stream to the first and second audio stations.
 5. Thepatient/nurse call system of claim 4, further comprising a trafficmanagement device coupled to the packet based communication network andthe second packet based network to manage transmission of the packetbased data streams between the first and second audio stations.
 6. Thepatient/nurse call system of claim 1, further comprising a plurality ofdata devices coupled to the packet based communication network, theplurality of devices being configured to send and receive data packetsover the communication network.
 7. The patient/nurse call system ofclaim 6, further comprising a server coupled to the packet basedcommunication network, the server being configured to manage theplurality of devices and to prioritize data packets associated with eachdevice.
 8. The patient/nurse call system of claim 7, wherein theprocessing of packets associated with a lower priority is delayed untilprocessing of packets with a higher priority is complete.
 9. Thepatient/nurse call system of claim 8, wherein packets containing voicedata are associated with a highest priority.
 10. The patient/nurse callsystem of claim 1, wherein the packet based communication network is anasynchronous network.
 11. The patient/nurse call system of claim 1,further comprising a data device coupled to the communication network,the data device being configured to receive the identification signalsfrom the plurality of transmitters and to provide the signals to themaster station via the packet based communication network.
 12. Thepatient/nurse call system of claim 11, wherein the data device isfurther configured to receive at least one of bed status signals, chaircall signals, shower status signals, and remote code signals.
 13. Thepatient/nurse call system of claim 1, wherein at least one of thepatient locations is a hospital bed, a first audio station being coupledto the hospital bed.
 14. The patient/nurse call system of claim 13,further comprising a data device coupled to the first audio station onthe hospital bed, the data device including at least one of apsychological monitor, a treatment device, and a therapy device, thefirst audio station being configured to receive data from the datadevice, convert the data received from the data device to a packet baseddata stream, and transmit the packet based data stream to the packetbased communication network.
 15. The patient/nurse call system of claim14, wherein a plurality of data devices coupled to the computer includean input device to input data and instructions concerning the patient,and a sensing device including at least one of a heart rate sensor, arespiratory rate sensor, a neurological monitoring sensor, and atemperature sensor.
 16. The patient/nurse call system of claim 14,wherein the data device includes at least one of a vital signs monitor,an IV pump, a ventilator, a defibrilator, and a compression boot. 17.The patient/nurse call system of claim 1, wherein at least one of thepatient locations is a patient assist cart, a first audio station beingcoupled to the patient assist cart.
 18. A patient/nurse call systemcomprising: a packet based communication network; a plurality oftransmitters, each of the transmitters being configured to be carried bya hospital caregiver and to periodically transmit an identificationsignal that identifies the transmitter; a plurality of receiversconfigured to receive the identification signals and generateidentification data corresponding thereto, the receivers beingconfigured to convert the identification data into a packet based datastream and to transmit the packet based data stream over thecommunication network; a first audio station coupled to the packet basedcommunication network and being identified by a unique address, thefirst audio station including a first processor, a first microphone, afirst speaker, and a first converter configured to receive audio signalsfrom the first microphone, to generate voice data in a packet based datastream corresponding thereto, and to transmit the packet based datastream over the communication network, the first converter also beingconfigured to receive a packet based data stream from the communicationnetwork, to generate audio signals corresponding thereto, and totransmit the audio signals to the first speaker; a second audio stationcoupled to the packet based communication network and being identifiedby a unique address, the second audio station including a secondprocessor, a second microphone, a second speaker, and a second converterconfigured to receive audio signals from the second microphone, togenerate voice data in a packet based data stream corresponding thereto,and to transmit the packet based data stream over the communicationnetwork, the second converter also being configured to receive a packetbased data stream from the communication network, to generate audiosignals corresponding thereto, and to transmit the audio signals to thesecond speaker; and a server coupled to the receivers, the first audiostation, and the second audio station via the packet based communicationnetwork, the server being configured to instruct the first audio stationand the second audio station regarding at least one of establishing anaudio connection and terminating an audio connection based at least inpart on the identification data, thereby permitting audio communicationbetween personnel located at the first and second audio stations. 19.The patient/nurse call system of claim 18, wherein the receiver isfurther configured to generate location data based at least in part onthe identification signals, and the server is further configured toinstruct the first audio station and the second audio station regardingat least one of establishing an audio connection and terminating anaudio connection based at least in part on the location data.
 20. Amethod for patient and nurse communication over a hospital network, themethod comprising the steps of: receiving at least one of anidentification signal from a transmitter carried by a hospitalcaregiver, a bed status signal, a chair call signal, a shower statussignal, and a remote code signal; generating non-voice datacorresponding to the received signal; generating voice data; sending afirst notification packet from a first address into a packet network;sending a first request packet from a second address into the packetnetwork in response to the first notification packet; transporting thenon-voice data in packets between the first address and the secondaddress in response to the first notification packet and the firstrequest packet; and transporting the voice data in packets between thefirst address and the second address in response to the firstnotification packet and the first request packet.
 21. The patient/nursecall method of claim 20, further comprising the steps of prioritizingpackets by a plurality of priority levels, and delaying processing oflower priority packets until higher priority packets are processed. 22.The patient/nurse call method of claim 21, wherein packets containingthe voice data are associated with the higher priority and packetscontaining the non-voice data are associated with the lower priority.23. The patient/nurse call method of claim 22, wherein the delaying ofthe packets is based at least in part on a number of audio connections.24. The patient/nurse call method of claim 23, further comprising thesteps of: segmenting the packet network into a first segment and asecond segment; and managing traffic between the first segment and thesecond segment by directing packets to addresses on the first segmentand the second segment.
 25. A patient support apparatus comprising: apatient support; a computer coupled to the patient support, the computerproviding an audio station on the patient support configured tocommunicate with a packet based communication network; a display coupledto the computer; and a data device coupled to the computer, the datadevice including at least one of a psychological monitor, a treatmentdevice, and a therapy device, the computer being configured to receivedata from the data device, convert the data received from the datadevice to a packet based data stream, and transmit the packet based datastream to the packet based communication network.
 26. The apparatus ofclaim 25, wherein a plurality of data devices coupled to the computerinclude an input device to input data and instructions concerning thepatient, and a sensing device including at least one of a heart ratesensor, a respiratory rate sensor, a neurological monitoring sensor, anda temperature sensor.
 27. The apparatus of claim 25, wherein the packetbased communication network provides for remote monitoring of patientdata and remote inputting of data and instructions.
 28. The apparatus ofclaim 25, wherein the apparatus further comprises a video imaging devicecoupled to the computer to provide images of the patient.
 29. Theapparatus of claim 25, wherein the data device includes at least one ofa vital signs monitor, an IV pump, a ventilator, a defibrilator, and acompression boot.
 30. The apparatus of claim 25, wherein the patientsupport is a hospital bed.
 31. The apparatus of claim 25, wherein thepatient support is a patient assist cart.